Amin A, et al. - Researchers assessed US Medicare enrollees with non-valvular atrial fibrillation (NVAF) and heart failure (HF) starting DOACs (apixaban, rivaroxaban, dabigatran) or warfarin for the risk of stroke/systemic embolism (SE), major bleeding (MB), and major adverse cardiac events (MACE) comparing direct oral anticoagulants (DOACs) vs warfarin and vs DOACs. matched pairs identified were 10,570 apixaban-warfarin, 4,297 dabigatran-warfarin, 15,712 rivaroxaban-warfarin, 4,263 apixaban-dabigatran, 10,477 apixaban-rivaroxaban, and 4,297 dabigatran-rivaroxaban. Rates of stroke/SE, MB, and MACE were lower with apixaban vs warfarin. Lower rates of MACE were noted with dabigatran and rivaroxaban. A lower stroke/SE rate and higher MB rate were noted with rivaroxaban vs warfarin. Apixaban led to lower MB and MACE rates vs dabigatran and rivaroxaban, respectively. Lower MACE rates were noted with all DOACs vs warfarin.